Collaborative care in the addiction management of alcohol, illicit drugs and hypnotics and tranquilizers in the Belgian working population

Background: General practitioners (GPs) and occupational physicians (OPs) play an important role in detecting and managing substance abuse in the working population. Their collaboration is critical in coordinating care, facilitate a quicker rehabilitation and shorten sickleave. A systematic literature search was performed according to the ADAPTE-framework to explore if guidelines exist for collaboration between GPs and OPs in substance abuse management.
Method: International guidelines regarding collaborative care for alcohol abuse, illicit drug use and hypnotics and tranquilizers were identified by a detailed systematic search in the Guidelines International Network (GIN) and US National Guidelines Clearinghouse (NGC) databases.
Results: In total 20 guidelines were considered of sufficient methodological quality, based on criteria of the Appraisal of Guidelines for Research and Education (AGREE) II instrument.
Two out of 20 eligible guidelines reported on the role of OPs. There is a lack of adequate evidence on the role of the OP in substance abuse management. No practical avenues for collaboration between GPs and OPs in the management of substance abuse were suggested.
Conclusions: In order to ensure adequate substance abuse management, collaborative models for general practice and occupational health should be developed. We recommend to study pros and cons for collaboration as well as the best way to achieve it.